he Impact of Reward, Punishment, and Frustration on ttention in Pediatric Bipolar Disorder

ackground: Theories in affective neuroscience suggest that mood disorders involve perturbations in attention–emotion interactions. e tested the hypothesis that frustration adversely impacts attention and behavior in children with bipolar disorder (BPD). ethods: Thirty-five children with BPD and 26 normal control subjects completed: 1) a Posner attention task with feedback but no ontingencies; 2) an affective Posner with contingencies; and 3) an affective Posner that used rigged feedback to induce frustration. eaction time (RT) and event-related potential (ERP) data were collected. esults: At baseline (task 1), there were no between-group differences in behavior or ERPs. Children with BPD exhibited reduced arietal P3 amplitude on task 3 only. On trials occurring after negative feedback, control subjects showed decreased RT when ontingencies were introduced (task 2), whereas BPD subjects did not. onclusions: The introduction of contingencies was associated with impaired performance of children with BPD, suggesting deficits n their ability to adapt to changing contingencies. In addition, frustration was associated with disrupted attention allocation in hildren with BPD. We hypothesize that children with BPD inappropriately deployed attention to their internal frustration rather than o the task, causing impaired performance.